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Comment on "The Role of the Vitreous Zonule in Preoperative Diagnosis of Zonular Laxity in Primary Angle-Closure Disease" [Letter]. 关于“玻璃体小体在原发性闭角症小体松弛术前诊断中的作用”的评论[信]。
Pub Date : 2025-11-26 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S581282
Luxing Xu, Yonggang Duan, Xuelin Wang
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引用次数: 0
Flutter Sign - An Indicator of Intact Anterior Hyaloid Face After Posterior Capsule Rupture During Phacoemulsification. 颤振征象——超声乳化术中后囊膜破裂后玻璃体前部完整的一个指标。
Pub Date : 2025-11-26 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S559799
Rohit Om Parkash, Tushya Om Parkash, Trupti Sharma, Rasik Behari Vajpayee, Deepak Megur, Sourabh D Patwardhan, Abhijeet Desai, Marie-José Tassignon

Purpose: To describe the intraoperative Flutter Sign as a real-time indicator of anterior hyaloid face (AHF) integrity following posterior capsule tear (PCT) during phacoemulsification.

Design: Single-centre observational study combining retrospective review of twelve intraoperative PCT cases with prospective evaluation of eight additional cases. Retrospective observations guided structured assessment in the prospective arm, focusing on PCT edge behaviour and AHF integrity.

Methods: Surgical videos of twelve eyes with intraoperative PCT were analysed for tear edge morphology and motility. Based on these findings, eight prospectively observed PCT cases were examined intraoperatively for edge behaviour and AHF status. Additional parameters included need for vitreous surgery, type of intraocular lens (IOL) implanted, and intraoperative and postoperative complications associated with PCT.

Results: Eleven eyes demonstrated sharp, fluttering PCT edges with intact AHF, no vitreous prolapse, and no need for anterior vitrectomy. Of these, five received in-the-bag IOLs, while six underwent sulcus fixation. All achieved a best corrected visual acuity (BCVA) of 20/20. Nine eyes exhibited scalloped, non-fluttering edges, consistent with AHF rupture and vitreous prolapse. All required anterior vitrectomy and sulcus-fixated IOLs. Three patients in this group experienced posterior migration of lens material: two had small cortical or nuclear fragments that were clinically insignificant and required no intervention, while one patient had a large nuclear fragment that necessitated a secondary procedure for removal. BCVA was reduced in two eyes to 20/30. Two patients experienced transient elevation of intraocular pressure. No cases of retinal detachment or endophthalmitis were observed.

Conclusion: The Flutter Sign is a simple, dye-free, real-time indicator of AHF integrity after PCT, with fluttering edges signifying intact AHF and scalloped static edges indicating vitreous prolapse.

目的:描述术中颤振征象作为超声乳化术中后囊撕裂(PCT)后前透明体面(AHF)完整性的实时指标。设计:单中心观察性研究,对12例术中PCT病例进行回顾性分析,并对另外8例进行前瞻性评价。回顾性观察指导前瞻性组的结构化评估,重点关注PCT边缘行为和AHF完整性。方法:对12只眼的术中PCT手术录像进行分析,观察泪缘形态及运动情况。基于这些发现,8例前瞻性观察PCT病例术中检查边缘行为和AHF状态。其他参数包括玻璃体手术的需要、人工晶状体(IOL)植入的类型以及与PCT相关的术中和术后并发症。结果:11只眼显示PCT边缘尖锐、抖动,AHF完整,无玻璃体脱垂,无需前玻璃体切除术。其中5例接受袋内人工晶状体,6例接受沟内固定。所有患者的最佳矫正视力(BCVA)均为20/20。9只眼睛呈扇形,边缘不抖动,与AHF破裂和玻璃体脱垂一致。所有患者均需要前路玻璃体切除术和沟固定人工晶状体。本组中有3例患者晶状体物质后移:2例患者有小的皮质或核碎片,临床上不明显,无需干预,而1例患者有大的核碎片,需要进行二次手术切除。2只眼BCVA降至20/30。2例患者出现短暂性眼压升高。无视网膜脱离或眼内炎病例。结论:颤振征象是PCT后AHF完整性的一种简单、无染色、实时的指标,颤振边缘表示AHF完整,扇形静态边缘表示玻璃体脱垂。
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引用次数: 0
Comparing Ophthalmologist and Artificial Intelligence Chatbot Responses to Patient Questions. 比较眼科医生和人工智能聊天机器人对患者问题的回答。
Pub Date : 2025-11-25 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S549820
Mostafa Bondok, Rishika Selvakumar, Christine Law, Edsel B Ing, Nupura K Bakshi, Tina Felfeli

Purpose: We evaluated the ability of ChatGPT, an Artificial Intelligence (AI) Chatbot, to respond to patient eye health queries.

Methods: A retrospective, cross-sectional analysis of eye health questions and physician responses posted on the American Academy of Ophthalmology (AAO) "Ask an Ophthalmologist" forum was performed on a random sample from January 2016 to December 2022. We compared board-certified ophthalmologists' responses to ChatGPT (version GPT-4o, OpenAI) responses in September 2024. Primary outcomes included ophthalmologist-rated accuracy of ChatGPT and AAO responses using a 7-point Likert scale, as well as ophthalmologists' preferences between the two responses. Secondary outcomes assessed differences in readability, empathy, and response length between ChatGPT and ophthalmologists.

Results: A random sample 250 questions and responses from 41 board-certified ophthalmologists were evaluated. ChatGPT and AAO responses had similar mean accuracy ratings (5.8 [SD=1.1] vs 5.5 [SD=1.1], p=0.07). Evaluators preferred ChatGPT over physician responses in half (49.5%) the cases. Ophthalmologist responses were easier to understand, with a lower mean Flesch-Kincaid Grade Level (Grade 11.0 [SD=2.7] vs Grade 12.7 [SD=1.9], p<0.001). Ophthalmologist responses were also significantly shorter than ChatGPT responses (80.6 [SD=56.4] words vs (337.8 [SD=141.6] words, p<0.001). Empathy ratings did not differ significantly between ChatGPT and ophthalmologists (4.4 [SD=0.6] vs 4.4 [SD=0.6], p=0.5).

Conclusion: Our findings suggest that Chatbot responses were as frequently preferred as physician responses, rated with higher accuracy, and demonstrated comparable empathy in addressing online patient eye health queries. AI chatbots may assist in drafting initial responses to patient concerns, potentially improving efficiency and reducing physician workload.

目的:我们评估了人工智能聊天机器人ChatGPT对患者眼睛健康问题的响应能力。方法:对2016年1月至2022年12月期间在美国眼科学会(AAO)“询问眼科医生”论坛上发布的眼部健康问题和医生回复进行回顾性、横断面分析。我们比较了委员会认证的眼科医生在2024年9月对ChatGPT(版本gpt - 40, OpenAI)的回应。主要结果包括眼科医生使用7分李克特量表评定ChatGPT和AAO反应的准确性,以及眼科医生对两种反应的偏好。次要结果评估了ChatGPT和眼科医生在可读性、同理心和反应时间方面的差异。结果:随机抽取了来自41名眼科医师的250个问题和回答进行评估。ChatGPT和AAO反应的平均准确度评分相似(5.8 [SD=1.1] vs 5.5 [SD=1.1], p=0.07)。在一半(49.5%)的病例中,评估者更喜欢ChatGPT而不是医生的回答。眼科医生的回答更容易理解,平均Flesch-Kincaid等级水平较低(11.0级[SD=2.7] vs 12.7级[SD=1.9])。结论:我们的研究结果表明,聊天机器人的回答与医生的回答一样受欢迎,评分准确率更高,并且在解决在线患者眼睛健康问题时表现出相当的同情心。人工智能聊天机器人可以帮助起草对患者问题的初步回应,从而提高效率并减少医生的工作量。
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引用次数: 0
Feedback on "The Impact of Workflow Modifications in an Electronic Medical Record on Tertiary Service Referrals for Patients with Visual Impairment in New York City" [Letter]. 关于“纽约市视障患者电子病历中工作流程修改对三级服务转诊的影响”的反馈[信件]。
Pub Date : 2025-11-25 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S581506
Avid Wijaya, Prima Soultoni Akbar, Ika Wijayanti
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引用次数: 0
Social Determinants of Health and Barriers in Accessing Eye Care for Refugees in the Greater Toronto Area. 大多伦多地区难民健康的社会决定因素和获得眼科护理的障碍。
Pub Date : 2025-11-24 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S557566
Mohammed Abbas, Khaldon F Abbas, Mariam Issa, Eric S Tam, Sohel Somani

Purpose: To evaluate ocular health status, vision-related quality of life, and access to eye care services among a multi-ethnic refugee population in the Greater Toronto Area (GTA).

Methods: Participants completed a structured survey capturing demographic, medical, and vision-related data. Descriptive statistics were employed to summarize and interpret the responses. Canadian population data were sourced from Statistics Canada and National Vision Health Reports. Participants were recruited during ophthalmic screening outreach visits at four refugee housing sites in the GTA, and were eligible if they were adults or mature minors residing in refugee homes after arriving in Canada as refugees or asylum seekers between October 2022 and October 2024. Proportions were converted to estimated counts for comparison, and harmonized categorical variables were analyzed using Pearson's Chi-Square or Fisher's Exact Test. Bivariate and multivariate logistic regression models were then used to assess associations between demographic, clinical, and psychosocial factors and two outcomes: difficulty coping with life due to vision and history of barriers to eye care.

Results: Among 94 refugee participants (mean age 46.5 years; 41% female), rates of recent eye exams (19.1%) and prescription glasses use (51.1%) were significantly lower than in the Canadian population (74.5% and 81.0%, respectively; p<0.0001). Over half (55.3%) were dissatisfied with their vision, and financial barriers (50%) were the most reported obstacle to care. Prior abuse was associated with greater odds of encountering barriers (OR=7.65, p=0.005), while dissatisfaction with vision (OR=0.11, p=0.025) and interference with daily activities (OR=233.0, p<0.0001) strongly predicted difficulty coping.

Conclusion: Refugees face significant vision-related health disparities. Interventions should address access, government benefits, education, and psychosocial supports.

目的:评估大多伦多地区(GTA)多民族难民的眼部健康状况、视力相关的生活质量和获得眼科保健服务的机会。方法:参与者完成一项结构化调查,收集人口统计、医疗和视觉相关数据。采用描述性统计对调查结果进行总结和解释。加拿大人口数据来自加拿大统计局和《国家视力健康报告》。参与者是在大多伦多地区四个难民住房点的眼科筛查外展访问期间招募的,如果他们是2022年10月至2024年10月期间作为难民或寻求庇护者抵达加拿大后居住在难民家中的成年人或成年未成年人,则符合条件。将比例转换为估计计数进行比较,并使用皮尔逊卡方或费雪精确检验对协调的分类变量进行分析。然后使用双变量和多变量逻辑回归模型来评估人口统计学、临床和社会心理因素与两种结果之间的关系:由于视力和眼部护理障碍史导致的生活困难。结果:在94名难民参与者中(平均年龄46.5岁,41%为女性),近期眼科检查率(19.1%)和处方眼镜使用率(51.1%)显著低于加拿大人口(分别为74.5%和81.0%)。结论:难民面临明显的视力相关健康差异。干预措施应涉及获取、政府福利、教育和社会心理支持。
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引用次数: 0
Real-World Visual and Anatomical Outcomes of Laser Therapy versus Intravitreal Anti-Vascular Endothelial Growth Factor Injection for Retinopathy of Prematurity: A 10-Year Retrospective Cohort Study at a Tertiary Center in Thailand. 激光治疗与玻璃体内注射抗血管内皮生长因子治疗早产儿视网膜病变的实际视觉和解剖结果:泰国一家三级中心的10年回顾性队列研究。
Pub Date : 2025-11-24 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S562553
Supanat Thanomteeranant, Thansit Srisombut, Sivapoj Sriwannavit, Pharuhad Pongmee, Tharikarn Sujirakul, Thitiporn Thongborisuth, Boontip Tipsuriyaporn

Purpose: To assess the visual and anatomical outcomes of retinopathy of prematurity (ROP) after treatment with laser therapy versus intravitreal anti-vascular endothelial growth factor (anti-VEGF) in real-world practice.

Methods: This retrospective cohort study included preterm infants with treatment-requiring ROP that underwent either laser indirect ophthalmoscopy (LIO) or intravitreal anti-VEGF therapy at Ramathibodi Hospital from January 2012 to October 2023.

Results: This study included 52 patients (104 eyes). The anti-VEGF (18 patients: 36 eyes) and LIO (34 patients: 68 eyes) groups had comparable baseline characteristics, including mean gestational age (25.80±2.81 vs 25.89±3.84 weeks; p=0.906), birth weight (693.0±34.30 vs 784.5±45.57 g; p=0.170), and mean follow-up duration (4.12±0.59 vs 4.91±0.57 years; p=0.361). Treatment occurred significantly earlier in the anti-VEGF group (postmenstrual age 33.94±0.53 vs 36.30±0.55 weeks; p=0.006). The anti-VEGF group required more follow-up visits from the initial exam until the complete regression of ROP (20.03±10.00 vs 11.80±6.03; p<0.001). The mean final visual acuity (VA) was similar between the anti-VEGF and LIO groups (logMAR 0.490 vs 0.480; p=0.852), although Zone I eyes treated with anti-VEGF tended to have better VA. Among Zone I eyes, those treated with anti-VEGF had significantly less myopia (mean spherical equivalent: -0.60 vs -12.30 D; p=0.007). Only the anti-VEGF group underwent secondary treatment, mainly for persistent avascular retina (44.4% vs 0%; p<0.001), and had treatment failure (16.7% vs 0%; p=0.002).

Conclusion: Both anti-VEGF and laser therapy demonstrated nonsignificant difference in functional and anatomical outcomes in treatment-requiring ROP. Notably, Zone I eyes treated with anti-VEGF exhibited significantly less myopia versus those treated with LIO. However, the anti-VEGF group required significantly more hospital visits and secondary treatments.

目的:评价激光治疗与玻璃体内抗血管内皮生长因子(anti-VEGF)治疗早产儿视网膜病变(ROP)后的视觉和解剖学结果。方法:这项回顾性队列研究纳入了2012年1月至2023年10月在Ramathibodi医院接受激光间接眼科检查(LIO)或玻璃体抗vegf治疗的需要治疗的ROP早产儿。结果:本研究纳入52例患者(104眼)。抗vegf组(18例:36只眼)和LIO组(34例:68只眼)具有相似的基线特征,包括平均胎龄(25.80±2.81 vs 25.89±3.84周;p=0.906)、出生体重(693.0±34.30 vs 784.5±45.57 g; p=0.170)和平均随访时间(4.12±0.59 vs 4.91±0.57年;p=0.361)。抗vegf组的治疗时间明显提前(经后年龄33.94±0.53 vs 36.30±0.55周;p=0.006)。抗vegf组从初始检查到ROP完全消退需要更多的随访(20.03±10.00 vs 11.80±6.03)结论:抗vegf和激光治疗在需要治疗的ROP的功能和解剖结果上无显著差异。值得注意的是,与LIO治疗相比,抗vegf治疗的I区眼的近视明显减少。然而,抗vegf组需要更多的医院就诊和二次治疗。
{"title":"Real-World Visual and Anatomical Outcomes of Laser Therapy versus Intravitreal Anti-Vascular Endothelial Growth Factor Injection for Retinopathy of Prematurity: A 10-Year Retrospective Cohort Study at a Tertiary Center in Thailand.","authors":"Supanat Thanomteeranant, Thansit Srisombut, Sivapoj Sriwannavit, Pharuhad Pongmee, Tharikarn Sujirakul, Thitiporn Thongborisuth, Boontip Tipsuriyaporn","doi":"10.2147/OPTH.S562553","DOIUrl":"10.2147/OPTH.S562553","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the visual and anatomical outcomes of retinopathy of prematurity (ROP) after treatment with laser therapy versus intravitreal anti-vascular endothelial growth factor (anti-VEGF) in real-world practice.</p><p><strong>Methods: </strong>This retrospective cohort study included preterm infants with treatment-requiring ROP that underwent either laser indirect ophthalmoscopy (LIO) or intravitreal anti-VEGF therapy at Ramathibodi Hospital from January 2012 to October 2023.</p><p><strong>Results: </strong>This study included 52 patients (104 eyes). The anti-VEGF (18 patients: 36 eyes) and LIO (34 patients: 68 eyes) groups had comparable baseline characteristics, including mean gestational age (25.80±2.81 vs 25.89±3.84 weeks; p=0.906), birth weight (693.0±34.30 vs 784.5±45.57 g; p=0.170), and mean follow-up duration (4.12±0.59 vs 4.91±0.57 years; p=0.361). Treatment occurred significantly earlier in the anti-VEGF group (postmenstrual age 33.94±0.53 vs 36.30±0.55 weeks; p=0.006). The anti-VEGF group required more follow-up visits from the initial exam until the complete regression of ROP (20.03±10.00 vs 11.80±6.03; p<0.001). The mean final visual acuity (VA) was similar between the anti-VEGF and LIO groups (logMAR 0.490 vs 0.480; p=0.852), although Zone I eyes treated with anti-VEGF tended to have better VA. Among Zone I eyes, those treated with anti-VEGF had significantly less myopia (mean spherical equivalent: -0.60 vs -12.30 D; p=0.007). Only the anti-VEGF group underwent secondary treatment, mainly for persistent avascular retina (44.4% vs 0%; p<0.001), and had treatment failure (16.7% vs 0%; p=0.002).</p><p><strong>Conclusion: </strong>Both anti-VEGF and laser therapy demonstrated nonsignificant difference in functional and anatomical outcomes in treatment-requiring ROP. Notably, Zone I eyes treated with anti-VEGF exhibited significantly less myopia versus those treated with LIO. However, the anti-VEGF group required significantly more hospital visits and secondary treatments.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"4301-4309"},"PeriodicalIF":0.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12661950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparing the Existing Myopic Keratorefractive Lenticule Extraction (KLEx) Platforms: A Narrative Review [Response to Letter]. 比较现有的近视角膜屈光透镜摘除(KLEx)平台:一个叙述性的回顾[回复信件]。
Pub Date : 2025-11-21 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S575546
Sabrina M Miller, Mina M Sitto, Kayvon A Moin, Phillip C Hoopes, Majid Moshirfar
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引用次数: 0
Patterns and Prevention of Occupational Eye Injuries: A Narrative Review. 职业性眼损伤模式与预防:述评。
Pub Date : 2025-11-20 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S556838
Victoria Vought, Francesca Zarbin, Rita Vought, Albert S Khouri

Occupational eye injuries (OEIs) remain a major public health issue despite regulatory efforts toward increasing protective eyewear use. OEIs encompass a wide spectrum of trauma, from superficial injury to tissue melt and globe rupture. These injuries are associated with substantial medical, economic, and social burden. This narrative review identifies risk factors associated with OEIs, differences based on workplace, and barriers to OEI prevention. Risks for OEI include male sex, low educational attainment, low income, or being a temporary or migrant worker. Certain industries such as metalworking, construction and manufacturing, chemical handling, and agriculture, also carry unique ocular hazards that predispose workers to OEIs. Although many OEIs are minor, those that cause severe injury can result in permanent visual loss and blindness. Industrial and construction workers are frequently exposed to high-velocity foreign bodies (FBs) and blunt trauma, while agricultural workers are at elevated risk for open globe injuries, FBs and the vision-threatening sequalae of infection from organic material. Chemical injuries, although less common, are notable for high rates of bilateral eye involvement, often requiring urgent intervention. Unfortunately, most OEIs occur in the absence of proper protective eyewear. Barriers range from discomfort and poor fit, inadequate access, and lack of perceived need, all of which contribute to low compliance in various occupational settings. Current evaluations of behavioral and regulatory interventions to increase adherence show promise but with mixed results. Advances in protective eyewear technology that optimize comfort and usage tracking may be helpful for employers to ensure compliance. A comprehensive understanding of OEI mechanisms and the obstacles to increased protective eyewear use is critical to mitigate the impact of OEIs on workers.

尽管监管机构努力增加防护眼镜的使用,但职业性眼损伤(OEIs)仍然是一个主要的公共卫生问题。OEIs包括广泛的创伤,从表面损伤到组织融化和球体破裂。这些伤害与巨大的医疗、经济和社会负担有关。这篇叙述性综述确定了与OEI相关的风险因素、基于工作场所的差异以及预防OEI的障碍。OEI的风险包括男性、低教育程度、低收入或是临时或流动工人。某些行业,如金属加工、建筑和制造业、化学品处理和农业,也有独特的眼部危害,使工人易患oei。虽然许多oei是轻微的,但那些造成严重伤害的oei可能导致永久性视力丧失和失明。工业和建筑工人经常暴露于高速异物(FBs)和钝性创伤,而农业工人则面临开放性球体损伤、FBs和有机材料感染的视力威胁后遗症的高风险。化学伤害虽然不太常见,但双侧眼睛受累的发生率很高,通常需要紧急干预。不幸的是,大多数oei是在没有适当的防护眼镜的情况下发生的。障碍包括不适和不适合、不充分的接触和缺乏感知需求,所有这些都导致了各种职业环境中的低依从性。目前对提高依从性的行为和监管干预的评估显示出希望,但结果好坏参半。保护眼镜技术的进步,优化舒适度和使用跟踪可能有助于雇主确保合规。全面了解OEI机制和增加防护眼镜使用的障碍对于减轻OEI对工人的影响至关重要。
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引用次数: 0
Comparison of Surgical Outcomes of Graft Survival Rate Using Surgeon Cut versus Precut DSAEK Tissue. 手术切除与预切DSAEK组织移植成活率的比较。
Pub Date : 2025-11-20 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S534683
Rawan Hawsawi, Rafah Fairaq, AbdulAziz Mohammed Alrabah, Mohammed Al Mutlak

Purpose: To compare endothelial graft outcomes after DSAEK using pre-cut tissue and surgeon cut tissue in terms of final visual outcome and graft failure at 6 and 12 months postoperatively.

Patients and methods: This retrospective study examined patients who underwent DSAEK with CB or surgeon-prepared tissue for any etiology of endothelial dysfunction. Best-corrected visual acuity (BCVA), corneal thickness, endothelial cell count (ECC), and complications were examined before and throughout the 1-year postoperative period.

Results: Total number of cases is 98 eyes of 98 patients. Fifty-five surgeon-cut grafts were compared to 43 precut grafts. Preoperative visual acuity was >/= 20/60 in 1.8% and 0.0%, >20/60-20/200 in 21.8% and 7%, and less than 20/200 in 74.6% and 86.1% for surgeon cut and precut group respectively. Visual acuity at last follow-up was >/= 20/60 in 32.4% and 5.3%, >20/60-20/200 in 29.7% and 10.5%, and less than 20/200 in 37.8% and 84.2% for surgeon cut and precut group, respectively. At 6 months, 41 (83.7%) in the surgeon cut group and 27 (67.5%) in the precut groups completed the follow-up. Of these, 10 (24.4%) and 14 (32.6%) respectively, ended up with graft failure. The statistically significant difference in graft failure was maintained until 12 months: 37 (82.2%) in the surgeon cut group and 20 (58.8%) in the pre-cut group completed the follow-up. Of these, 11 (29.7%) and 14 (70%) labeled as failed grafts, respectively.

Conclusion: We found a higher rate of graft failure 6 to 12 months postoperatively in precut tissue grafts than in surgeon cut tissue grafts despite both tissues being provided by the same eye banks.

目的:比较DSAEK术后预切组织和手术切组织的最终视力结果和术后6个月和12个月的移植失败。患者和方法:本回顾性研究检查了在CB或外科准备的组织中接受DSAEK的任何内皮功能障碍病因的患者。术后1年检查最佳矫正视力(BCVA)、角膜厚度、内皮细胞计数(ECC)及并发症。结果:98例患者共98只眼。55例手术切除移植物与43例预切移植物相比。术前视力>/= 20/60分别为1.8%和0.0%,>20/60-20/200分别为21.8%和7%,低于20/200分别为74.6%和86.1%。手术切除组和预切组最后一次随访时视力分别为>/= 20/60的32.4%和5.3%,>20/60-20/200的29.7%和10.5%,低于20/200的37.8%和84.2%。6个月时,手术切除组41例(83.7%)完成随访,预切组27例(67.5%)完成随访。其中10例(24.4%)和14例(32.6%)以移植物衰竭告终。有统计学意义的移植失败持续到12个月:手术切除组有37例(82.2%)完成随访,预切组有20例(58.8%)完成随访。其中,11例(29.7%)和14例(70%)分别标记为移植物失败。结论:我们发现,尽管两种组织由同一眼库提供,但预切组织移植术后6至12个月的移植失败率高于外科手术切除组织移植。
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引用次数: 0
Surgical Outcomes of Lens Removal with or Without Intraocular Lens Implantation in Marfan Syndrome: A Retrospective Cohort Study. 马凡氏综合征患者晶状体摘除伴或不伴人工晶状体植入术的手术结果:一项回顾性队列研究。
Pub Date : 2025-11-17 eCollection Date: 2025-01-01 DOI: 10.2147/OPTH.S557116
Halah Bin Helayel, Moustafa S Magliyah, Raed Alnutaifi, Abdulrahman H Badawi

Purpose: To evaluate the outcomes of lensectomy with and without intraocular lens (IOL) implantation in patients with Marfan syndrome and ectopia lentis.

Methods: This retrospective review included 55 patients (85 eyes) diagnosed with Marfan syndrome who underwent lens surgery at King Khaled Eye Specialist Hospital between 2014 and 2023. Preoperative lens status; surgical technique; use of capsular support devices and IOLs; and postoperative clinical, biometric, and refractive parameters were analyzed. The primary outcome was final best-corrected visual acuity. Secondary outcomes included refractive correction (spherical equivalent), axial length, intraocular pressure, IOL position and stability, and incidence of postoperative complications.

Results: All eyes had subluxated crystalline lenses [predominantly inferotemporal lenses (52.9%)]. Surgical procedures included lensectomy with anterior vitrectomy (49.4%), lensectomy with IOL implantation (38.8%), pars plana vitrectomy with lensectomy (7.1%), and phacoemulsification with IOL (4.7%). Capsular support devices were used in 12 eyes. Secondary IOL implantation was performed in 12 eyes, with 91.7% scleral-fixated IOLs. At the final follow-up, 41.2% of the eyes were aphakic, 32.9% had scleral-fixated IOLs, 15.3% had posterior chamber IOLs, and 8.2% had anterior chamber IOLs. There was a significant association between phakic status and refractive correction (P<0.001). The final mean visual acuity improved significantly from 1.1±0.7 logMAR (20/250) at presentation to 0.3±0.3 logMAR (20/40) at the last visit (P<0.001). The IOL position was stable in 47.1% of the eyes and was significantly associated with IOL type (P<0.001).

Conclusion: Lensectomy, with or without IOL implantation, is an effective and versatile approach for managing ectopia lentis in Marfan syndrome, with favorable long-term visual and anatomical outcomes. These findings emphasize the need for individualized planning based on subluxation severity and capsular support. Improved IOL stability and vision support the use of tailored techniques. Future studies should assess long-term safety and quality of life to guide standardized care.

目的:评价马凡氏综合征合并晶状体异位患者晶状体切除术合并人工晶状体植入术与不合并人工晶状体植入术的疗效。方法:回顾性分析2014年至2023年间在King Khaled眼科专科医院接受晶状体手术的55例(85只眼)马凡氏综合征患者。术前晶状体状态;手术技术;使用人工晶状体支撑装置和人工晶体;并分析术后临床、生物特征和屈光参数。主要结果为最终最佳矫正视力。次要结果包括屈光矫正(球面等效)、眼轴长度、眼压、人工晶状体位置和稳定性以及术后并发症的发生率。结果:所有眼晶状体均有半脱位(以颞下晶状体为主,占52.9%)。手术方式包括晶状体切除术合并前玻璃体切除术(49.4%)、晶状体切除术合并人工晶状体植入术(38.8%)、晶状体切除术合并晶状体切除术(7.1%)和晶状体超声乳化术合并人工晶状体植入术(4.7%)。12只眼采用囊膜支撑装置。二期人工晶状体植入术12眼,巩膜固定型人工晶状体占91.7%。最后随访时,无晶状眼占41.2%,巩膜固定型人工晶状眼占32.9%,后房型人工晶状眼占15.3%,前房型人工晶状眼占8.2%。结论:晶状体切除术合并或不合并人工晶状体植入术是治疗马凡氏综合征晶状体异位的一种有效和通用的方法,具有良好的长期视力和解剖效果。这些发现强调了基于半脱位严重程度和囊膜支持的个体化计划的必要性。改善的人工晶体稳定性和视力支持使用量身定制的技术。未来的研究应评估长期安全性和生活质量,以指导标准化护理。
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Clinical ophthalmology (Auckland, N.Z.)
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